The Bronx's Montefiore Medical Center has worked hard to develop state-of-the-art clinical IT systems. What are they doing right, and what does it mean for the future of health care?

The history of health care IT has not, in general, been a happy one. The industry has consistently underinvested in
IT, and thanks to the ongoing misalignment of interests among the patients, providers and payors, it doesn't look as if increased pooling of efforts and more IT investment will happen any
time soon.

Still, there are pockets of health in the health care landscape. Individual hospitals, as well as some insurers, continue to press for change in the use of IT so they can do their jobs better. One example is Montefiore Medical Center in the New York City borough of the Bronx. In keeping with its 15-year effort to expand from its stand-alone hospital base to integrate more hospitals and community-based ambulatory care units, Montefiore has embarked on a major effort to create clinical systems that combine single patient records, prescription order entry, and other elements that are tightly woven into the clinicians' workflow.

The team leading the hospital's IT effort includes Dr. Steven Safyer, senior vice president and chief medical officer; Jack Wolf, chief information officer; and Dr. Gary Kalkut, vice president and medical director. Editor Edward Baker spoke to the trio at their offices in the Bronx about the technological, political and cultural challenges of health care IT. An edited version of the conversation follows.

Edward Baker has a distinguished career in business and technology publishing. Most recently, he was assistant managing editor at The Daily Deal, overseeing venture capital and technology reporting. Previously, he was the editor of the Executive Edge, published by Forbes Special Interest Publishing in conjunction with the Gartner Group, editor of Forbes Critical Mass and managing editor of the Forbes Technology Buyers'Guide. Prior to that he was the senior editor at KPMG Peat Marwick. He was also the managing editor of Financial World and the editor of Mass Transit Magazine. He has edited several books, including: Juggernaut! The German Business Machine and Money Dynamics for Your Retirement Years.